Influence of access cavity design on calcium hydroxide removal using different cleaning protocols: a confocal laser scanning microscopy study

Objectives

The purpose of this study was to evaluate the influence of endodontic access cavities design on the removal of calcium hydroxide medication of the apical third of mandibular incisor root canal walls and dentinal tubules with different cleaning protocols: EDDY sonic activation, Er,Cr:YSGG laser-activated irrigation, or conventional irrigation with IrriFlex.

Materials and Methods

Seventy-eight extracted human mandibular incisors were assigned to 6 experimental groups (n = 13) according to the endodontic access cavity and cleaning protocol for calcium hydroxide removal: traditional access cavity (TradAC)/EDDY; ultraconservative access cavity performed in the incisal edge (UltraAC.Inc)/EDDY; TradAC/Er,Cr:YSGG; UltraAC.Inc/Er,Cr:YSGG; TradAC/IrriFlex; or UltraAC.Inc/IrriFlex. Confocal laser scanning microscopy images were used to measure the non-penetration percentage, maximum residual calcium hydroxide penetration depth, and penetration area at 2 and 4 mm from the apex. Data were statistically analyzed using Shapiro-Wilk and WRS2 package for 2-way comparison of non-normally distributed parameters (depth of penetration, area of penetration, and percentage of non-penetration) according to cavity and cleaning protocol with the significance level set at 5%.

Results

The effect of cavity and cleaning protocol interactions on penetration depth, penetration area and non-penetration percentage was not found statistically significant at 2 and 4 mm levels (p > 0.05).

Conclusions

The present study demonstrated that TradAC or UltraAC.Inc preparations with different cleaning protocols in extracted mandibular incisors did not influence the remaining calcium hydroxide at 2 and 4 mm from the apex.

Comparison of the opinions and attitudes of medical doctors, dentists and mothers toward teething symptoms

BACKGROUND

The signs and symptoms associated with teething can be local or systemic. It remains unclear whether the disturbances are caused by the eruption of primary teeth or whether they simply coincide with tooth eruption. Parents and healthcare professionals can have different perceptions about teething symptoms, especially in different cultural or socio-economic contexts.

OBJECTIVES

The study aimed to compare the opinions and attitudes of medical doctors, dentists and mothers toward the symptoms of teething.

MATERIAL AND METHODS

Data about the signs and symptoms was collected using a researcher-made questionnaire. The questionnaire was mailed in December 2019 to 800 randomly selected medical doctors and dentists working in the Central Aegean Region of Turkey. Mothers of children aged 0-3 years who were referred to the pediatric department were selected for the study. Data from 199 medical doctors (109 family physicians, 90 pediatricians), 293 dentists (169 general dentists, 124 pediatric dentists) and 352 mothers who completed the questionnaire was included in the study. The data was analyzed using the IBM SPSS Statistics for Windows program.

RESULTS

Each participant identified at least one symptom related to teething. Statistically significant differences were found between the 3 groups in terms of symptoms except for stomach ache (p < 0.05). Gingival irritation was the most common symptom among dentists (95.6%) and mothers (70.7%), while irritability was the most common symptom among medical doctors (90.5%). Mothers believed to a greater extent than the other groups that fever, vomiting and cough were associated with teething (p < 0.05), whereas medical doctors tended to point to drooling, irritability, biting/chewing, diarrhea, and ear rubbing more often than the other groups (p < 0.05). In addition, sleep disturbance and loss of appetite were associated with teething less frequently by mothers as compared to the other groups (p < 0.05).

CONCLUSIONS

In the present study, medical doctors, dentists and mothers reported unproven and controversial associations between teething and certain local or systemic symptoms. Mothers especially were more likely to believe that systemic symptoms that can be confused with other serious diseases were associated with teething.

Comparison of Shaping Ability between Continuous Rotary and Manual Instrumentations in Pediatric Endodontics

Objective: The aim of this in vitro study was to evaluate the efficacy of rotary EndoArt Ni-Ti Gold Pedo Kit and K-files in shaping ability, canal transportation, centering ability and instrumentation time in primary molars. Methods: For the study total of 30 extracted primary molars root with minimum 7mm root length were selected. Shaping of root canals in primary molars were done using the two systems, and CBCT and specialized software were used for scanning and analysis of pre-operative and post-operative to evaluate the groups for their shaping properties, apical transportation and preparation time in primary root canals. Results: No differences were found in canal transportation measures and instrumentation time between the two groups (p>0.05). The EndoArt group removed more dentin compared to K-file in all sides of the root curvature. The statistical differences were significant for coronal and middle third of the root (p<0.05). Conclusions: Under the conditions of this study, rotary EndoArt Ni-Ti Gold Pedo Kit provided more conical canals than K-files in primary teeth.

Evaluation of the fissure sealants applied to erupting permanent molars in accordance to eruption stages: A prospective study

Background

The aim of this study is to evaluate the clinical success of different fissure sealants applied to erupting permanent first molars by taking into consideration the stages of tooth eruption.

Materials and Methods

Two hundred healthy children between ages 5 and 8 with the inclusion criteria were examined. The erupting permanent first molars were evaluated and those at stage 3 or 4 were selected. An investigator placed three different fissure sealants (giomer, hydrophilic, and hydrophobic resin-based). At the end of 18 months, retention loss, development of new dental caries, localization of retention losses, marginal integrity, and marginal discoloration were evaluated.

Results

The rate of tooth with total retention at stage 3 was significantly higher (P < 0.05). The development of dental caries in teeth at stage 4 was found to be significantly higher than that of stage 3 (P < 0.05). In terms of marginal integrity, the difference between stages of tooth eruption is similar (P > 0.05). Regarding marginal discoloration, fissure sealants applied at stage 3 were considered to be more successful than those applied at stage 4 (P < 0.05).

Conclusions

We may conclude that the tooth eruption affects clinical success and giomer-based fissure sealants may not be an alternative for resin-based fissure sealants in erupting teeth.